Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Japan.
The First Department of Medicine, Wakayama Medical University, Japan.
Intern Med. 2023 Jul 1;62(13):1957-1963. doi: 10.2169/internalmedicine.0742-22. Epub 2022 Nov 23.
A 43-year-old man developed headache, dizziness, abdominal pain, and vomiting. His blood pressure was 203/121 mmHg, heart rate 122 beats/min, body temperature 39.1°C, and respiratory rate 24/min. He had elevated levels of creatinine at 2.95 mg/dL and lipase at 1,364 U/L as well as an extremely low calcium level at 5.2 mg/dL. Hypertriglyceridemia and hyperglycemia were seen. Chest and abdominal computed tomography showed interstitial pneumonia, severe pancreatitis, and a right adrenal tumor. The patient also developed vertebral artery dissection and medullary infarction. After right adrenalectomy, the patient was diagnosed with pheochromocytoma multisystem crisis (PMC). Acute pancreatitis might augment numerous life-threatening manifestations of PMC.
一位 43 岁男性出现头痛、头晕、腹痛和呕吐。他的血压为 203/121mmHg,心率 122 次/分,体温 39.1°C,呼吸频率 24 次/分。他的肌酐水平升高至 2.95mg/dL,脂肪酶升高至 1364U/L,血钙水平极低,仅为 5.2mg/dL。同时伴有高甘油三酯血症和高血糖症。胸部和腹部计算机断层扫描显示间质性肺炎、重症胰腺炎和右侧肾上腺肿瘤。患者还出现椎动脉夹层和延髓梗死。行右侧肾上腺切除术,患者被诊断为嗜铬细胞瘤多系统危象(PMC)。急性胰腺炎可能加重 PMC 的多种危及生命的表现。